Primary Health Need

What is a Primary Health Need?

In order to qualify for NHS Continuing Healthcare Funding (CHC), an individual needs to establish that they have a ‘Primary Health Need’ (also called a primary healthcare need or primary need for healthcare)

The National Framework for NHS Continuing Healthcare and NHS-funded nursing care defines a primary healthcare need as follows:

An individual has a primary health need if, having taken account of all their needs (following completion of the Decision Support Tool), it can be said that the main aspects or majority part of the care they require is focused on addressing and/or preventing health needs. Having a primary health need is not about the reason why an individual requires care or support, nor is it based on their diagnosis; it is about the level and type of their overall actual day-to-day care needs taken in their totality.

The Primary Health Need Test

In order to establish whether an individual has a Primary Health Need, you need to look at the totality of all their relevant needs and how they interact. Once the 12 domains of care have been completed on the Decision Support Tool, the Primary Health Need ‘test’ is then applied. These are the four “Key Characteristics” of nature, intensity, complexity and unpredictability. The Characteristics help determine whether the majority of care interventions are aimed at meeting health or social care needs. 

Broadly speaking, social care is assistance to do the things we all do every day – getting up, having a wash, getting dressed, going to the toilet, eating and drinking, moving around, keeping our environment clean and tidy, maintaining social relationships. This is what the NHS and Social Services describe as the “activities of daily living” or “ADL”. For the purposes of CHC assessments, even if a person is totally dependent on others to meet all their ADL, that would still be deemed as social care, unless the interventions required are complex (skilled), intense (labour/time-consuming) or unpredictable (rapidly fluctuating). 

Often, the dividing line is very narrow and subjective but the outcome will determine who pays the cost of care – the individual or the NHS! 

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From the moment I picked up the phone to Farley Dwek the stress levels we suffered dropped significantly as we had everything explained to us.

Gilmour Shelley

A sound investment! I had researched a number of firms offering assistance to help secure CHC funding for our Mum. I was very glad I chose Farley Dwek. Both my brother and I are retired solicitors and are able plough our way through regulatory material and legislation, However, neither of us had any experience in this area of law. I really appreciated Farley Dwek’s transparent and sensible advice. I would recommend doing the initial screening exercise with one of their nurses, we had the excellent Diane Jenkins for screening (and eventual support at the MDT).

CHC client

Without Farley Dwek’s support we wouldn’t have secured the funding. Soon after we presented our case with Farley Dwek we were informed by the NHS that my mother was entitled to the funding after all. It was a huge relief because the size of the care home fees can be a huge worry.

David Newton

Thanks to Andrew’s guidance, we were able to articulate and feedback our reservations to the CHC and they ended up ruling in our favour. We therefore did not end up having to formally instruct Farley Dwek for representation but our impression was that they were an exemplary firm with judicious invested leadership and noble ethics.

CHC client

My family and I cannot rate Farley Dwek Solicitors high enough for all their work in helping us with a successful appeal to grant my father CHC in his care home. As soon as I contacted them I felt listened to and supported and our solicitor Debbie was nothing short of incredible. Very knowledgeable in her field, always ready to offer insight and support and quick to respond to queries, we would have been lost without her! If you are looking for some advice and guidance on CHC’s look no further. Recommend without hesitation.

CHC client

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